Texas House Bill HB5343

Texas 2025 - 89th Regular

• Filed: 3/14/25

Caption

Relating to the reimbursement and payment of claims by certain health benefit plan issuers for telemedicine medical services, teledentistry dental services, and telehealth services.

Impact

This legislation is expected to significantly influence state laws governing telehealth. Given the increasing reliance on telemedicine and teledentistry, especially following the COVID-19 pandemic, HB5343 seeks to create a more equitable reimbursement framework. It will require health benefit plans to maintain parity between in-person and remote services, thereby encouraging providers to offer tailored telehealth solutions.

Summary

House Bill 5343 relates to the reimbursement and payment of claims for various telehealth services, specifically telemedicine medical services and teledentistry. The bill mandates that health benefit plan issuers must reimburse health professionals for telehealth services at the same rate as they would for in-person services. This aims to ensure that telehealth providers are compensated fairly, potentially improving the availability of these services across the state.

Contention

Notable points of contention may arise surrounding the bill's provisions, particularly the requirement that health plans must not require additional documentation for telehealth claims beyond what is typically needed for in-person visits. This clause may raise concerns among insurers about potential abuse or over-utilization of telehealth services. Additionally, the bill includes a stipulation that the provisions cannot be waived by contract, which could face pushback from insurance companies seeking more flexible arrangements.

Texas Constitutional Statutes Affected

Insurance Code

• Chapter 1455. Telemedicine, Teledentistry, And Telehealth
  • Section: 001
  • Section: New Section